Frequently Asked Questions (FAQs)
You may have several questions about the VETSmile program, but depending on how you plan to participate, the questions you ask may be different. We paired answers to commonly asked VETSmile questions for these three groups:
Veterans,
Potential Dental Care Partners
and
Veteran Affairs Medical Centers (VAMC).
For in-depth information, go to the section most relevant to you below.
Veterans
VETSmile is a program that connects Veterans with community dental care partners that may offer discounted care. The goal of this program, which is run by the Department of Veterans Affairs (VA) Center for Care and Payment Innovation (CCPI), is to provide access to continuous and comprehensive oral health care for Veterans Health Administration (VHA)-enrolled Veterans who are currently ineligible for dental benefits through VA.
Veterans enrolled in the VA health system who are not eligible to receive dental care through VA. Some dental care providers may have additional requirements.
Call your assigned dental care provider, and say that you are a Veteran requesting a VETSmile appointment. If there are multiple locations presented to you, you may choose the location you prefer.
Please bring the notification email or letter you received from the VA that has your VETSmile registration code.
For a full list, please go to your dental care provider’s website or ask when making your VETSmile appointment.
While VETSmile strives to work with DCPs that provide discounted care, each DCP may have different payment options in place. Please note: VA does not reimburse DCPs for the care Veterans receive. DCPs, on their own, determine how to help reduce or offset the cost of the dental care that Veterans receive.
Below are guided questions to ask on the phone when making your VETSmile appointment:
1. Are there any discounts or sliding scales that I may be eligible for?
2. Does your facility accept my insurance (e.g., Adult Medicaid, Delta Dental, Cigna,
United)?
3. What options do I have to pay for my dental care (e.g., personal check, money order,
credit/debit cards)?
4. Does your facility have a payment plan or payment financing?
It depends on the dental care provider. When a student dentist/doctor delivers care, faculty provides oversight to ensure the highest quality.
No. Travel and mileage reimbursement from VA for VETSmile appointments and treatment are not
covered. For more information:
www.va.gov/health-care/get-reimbursed-for-travel-pay
Potential Dental Care Partners
VETSmile is a new U.S. Department of Veterans Affairs (VA) Center for Care and Payment Innovation (CCPI) collaboration with community dental care partners (DCPs) to improve access to continuous and comprehensive oral health care for VHA-enrolled Veterans who are currently ineligible for dental benefits through VA.
Veterans who access dental care through the VA do so through an eligible service-connected disability or are 100% service-disabled Veterans. The VA defines a service-connected disability as a “physical or mental injury or condition that was ‘incurred or aggravated’ in the line of military duty, and that results in a disability. A service-connected disability need not be connected to combat or service during a period of war."
Eligible Veterans are those enrolled in the VA health system who are not eligible to receive dental care through VA.
The program intends to connect Veterans with basic dental care services (e.g., preventative oral care, cleanings, exams) as a minimum. DCPs can propose additional services to offer VETSmile patients.
There are no capacity requirements for the minimum number of VETSmile patients to treat at a time.
CCPI works with each dental care partner to establish additional criteria, as needed, to accommodate capacity for new Veteran patients (e.g., dental insurance status, residency).
After an initial introductory meeting with CCPI, interested dental care partners are provided a Memorandum of Agreement (MOA) following the initial call for signature. But, dental care partners may begin to work with Veterans regardless of whether or not the MOA is signed and approved.
VETSmile is congressionally mandated to continue through 2026. After the five-year pilot phase concludes, Congress and VA administrators will evaluate the program for further scaling or extending the pilot phase. Since the program is designed to provide Veterans a dental home where they can continue to receive comprehensive care for the rest of their lives, the conclusion of the pilot will not affect the Veterans already in the program.
DCPs can use their existing fee schedules to determine the cost of care for VETSmile patients. There are no requirements to provide a VETSmile-specific discount.
Not from VA. However, some DCPs have received grants and funding from philanthropic sources to help with costs at their particular pilot location(s). VA does not reimburse DCPs for the care Veterans receive. DCPs, on their own, determine how to help reduce or offset the cost of the dental care Veterans receive.
The VETSmile program includes data-related language in the MOA that explicitly details the following:
1. Data usage, 2. Transfer, 3. Sharing, 4. Consent, 5. Security, 6. Privacy
VETSmile will be collecting only summary-level data on a monthly basis while efforts are underway to create a secure web submission portal for PHI/PII data.
DCPs can request CCPI to sign a data use agreement, but data use agreement requests come from the DCP.
Veterans Affairs Medical Centers (VAMC)
The VETSmile pilot program connects eligible Veterans, who do not have a VA dental benefit, to community dental partners. This care is not funded by VA; however, CCPI is targeting Federally Qualified Healthcare Centers and dental schools who may have the ability to provide reduced-fee dental care.
Veterans are connected to community dental providers using two methods: the Cohort Model and the Referral Model. In both models, all dental care is managed by accredited community dental providers.
The Cohort Model:
The CCPI VETSmile team pulls names and addresses of Veteran enrollees who are not eligible for VA dental benefits. Based on capacity and input from the dental care partners (DCPs), Veterans are contacted directly by CCPI, via email and mail, to notify them of their eligibility to participate in the VETSmile program. This outreach provides contact information to the participating community dental provider. The Veteran would then reach out to that provider and become their established patient for ongoing dental care needs.
The Referral Model:
Local VAMC medical providers refer patients to community dental providers through the Consult Toolbox; medical providers receive Veteran permission to share their name and contact information to community dental providers to be scheduled for dental care. Please note that there is no coordination or approval of services with VA Dentistry.
A more in-depth implementation guide will be provided to participating VAMCs, and the CCPI
project team will work closely with VAMCs to facilitate the process.
CCPI partners with local VAMCs to implement the Referral Model for Veterans who are not eligible for VA Dental benefits. CCPI will work with VAMC medical providers and DCPs to create a bridge for patient referrals and will support the VAMC with a Consult Toolbox to implement the VETSmile pilot program.
No. VA Dentistry serves enrolled Veterans who are eligible for VA dental services, while VETSmile is only authorized to connect enrolled Veterans who are not eligible for VA dental services to community providers. The VETSmile pilot program is being administered through the VHA Center for Care and Payment Innovation, an office within the VHA Office of Healthcare Innovation and Learning, which is a core program office under the Discovery, Education, and Affiliate Networks (14 DEAN). VA Dentistry is briefed monthly on the program and provides insights and suggestions as needed.
All communication related to the VETSmile pilot program, including those pertaining to the patient experience, should be referred to the Center for Care and Payment Innovation at vetsmile.vaco@va.gov
The VETSmile pilot program, and specifically the Referral Model, described above, was designed to be driven by referrals from medical providers. This is because VA Dentistry is solely authorized to see patients who are eligible for VA dental benefits, so they do not interact as much with the Veterans that this pilot is meant to target. In VAMCs where the program has been deployed, Primary Care and/or the Chief of Staff’s Office is implementing the program. While CCPI does not direct which service should serve as facility lead, it is recommended that facility leads for the VETSmile Program be part of a non-dental service to reach as many Veterans with non-dental benefits as possible.
For both models, CCPI collects high-level, non-PHI/PII data from Veterans who are seen through the VETSmile pilot program, with the intent of using that data to identify positive population health outcomes, determine long-term pilot feasibility and support potential scaling.
The VETSmile Pilot Program has been authorized by Congress to run for five years. At the end of this time period, CCPI will evaluate the results of the pilot program and make recommendations to Congress on the future direction of VETSmile. Veterans already connected to dental care providers will not be impacted by pilot duration. Once the veteran is connected to a dental provider, they are the patient of that provider for their lifetime.
While Community Care serves Veterans with a VA dental benefit and pays for care that these Veterans receive in the community, the VETSmile pilot program is designed to connect Veterans who do not have a VA dental benefit with community providers. VA does not pay for this care but works specifically with Federally Qualified Healthcare Centers and dental schools to create a network of dental providers who can offer pro bono or discounted dental services, with the ultimate goal of providing the Veteran with a dental home.
If facilities are interested in participating in the VETSmile pilot program, please reach out to the VETSmile Project Manager at the Center for Care and Payment Innovation using vetsmile.vaco@va.gov. The Project Manager will work with facilities to initiate the implementation process as the VETSmile pilot program is deployed in each region/state.